Shoulder

Question 1

Presentation of adhesive capsulitis

Answer 1

Often non-traumatic
Acute phase, middle phase, final phase
Often self-resolves in 2-3 years

Question 2

Acute phase of adhesive capsulitis

Answer 2

Moderate to severe pain that limits ROM

Question 3

Middle phase of acute capsulitis

Answer 3

Less pain but describes lifting arm and internal/external rotation is severely restricted

Question 4

Final phase of adhesive capsulitis

Answer 4

Slowly increased ROM

Question 5

3 stages of adhesive capsulitis s

Answer 5

Freezing, frozen, thaw

Question 6

Cause of adhesive capsulitis

Answer 6

Unknown
Slight increase in diabetes, hyperthyroidism, COPD
Inflammation leads to fibrosis

Question 7

Epidemiology/risk factors for adhesive capsulitis

Answer 7

45-60 yoa, 70% female, prolonged immobility, previous injury, previous surgery, diabetes, hypothyroidism

Question 8

Adhesive capsulitis diagnosis

Answer 8

Based on history, loss of shoulder ROM, Mazion shoulder test

Question 9

Adhesive capsulitis treatment

Answer 9

Most cases improve within 2 years without treatment, treatment depends on phase of condition

Question 10

Treatment of phase 1 adhesive capsulitis

Answer 10

Avoid aggressive adjustments, focus on mobilization, isometric exercises, codman’s exercises, sleep on unaffected side

Question 11

Treatment of phase 2/3 adhesive capsulitis

Answer 11

Adjust and mobilize shoulder, codmans exercises, isometric exercises, stretching

Question 12

Medical co-management of adhesive capsulitis

Answer 12

Arthroscopic surgery, pain killers, corticosteroid injection, manipulation under anesthesia

Question 13

Impingement syndrome anatomy

Answer 13

Rotator cuff muscle tendons pass through a narrow space between the acromion process of the scapula and the head of the humerus

Question 14

Impingement syndrome causes

Answer 14

Anything which causes further narrowing of the space can result in impingement syndrome
-bony structures such as subacromial spurs
-osteoarthritis spurs on the acromioclavicular joint
-variations in the shape of the acromion

Question 15

Type 1 acromion process variation

Answer 15

Normal—flat

Question 16

Type 2 acromion process variation

Answer 16

Gently curved

Question 17

Type 3 acromion process variation

Answer 17

Hooked—will likely cause more issues to soft tissues

Question 18

Impingement syndrome s/s

Answer 18

Pain, weakness, pain at night sleeping on affected shoulder, limited ROM, painful arc of movement from 60-120 degrees, passive movement is painful

Question 19

Impingement syndrome diagnosis

Answer 19

History of painful arc, grinding or popping, physical exam, x-ray of shoulder

Question 20

Co-management of impingement syndrome

Answer 20

Consult (surgical—if conservative methods fail), acupuncture, physical therapy

Question 21

Treatment of impingement syndrome

Answer 21

Progression from isometrics to isotonic exercises, ice, superior to inferior adjustments of GH joint

Question 22

Contraindicated adjustments for impingement syndrome

Answer 22

S-I AC joint

Question 23

Good adjustments for impingement syndrome

Answer 23

I-S adjustments of sternoclavicular joint and GH joint, S-I adjustment of GH joint